Title

Author

Date of Award

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Dr. C. Richard Spates

Second Advisor

Dr. James A. Gilchrist

Third Advisor

Dr. Malcolm H. Robertson

Fourth Advisor

Dr. Lester W. Wright

Abstract

This study sought to examine the effect of providing outcome assessment data to therapists treating a sample of community adults seeking mental health services at two university training clinics. The participants (N = 41) were predominantly unmarried, Caucasian females, 19 to 39 years old, with a wide range of psychological problems. The therapists were trainees from master’s and doctoral programs in counseling and clinical psychology participating in their first clinical practicums. The Outcome Questionnaire 45-2 (OQ), an instrument designed for frequent measurement of client symptom, interpersonal, and social-role distress, served as the dependent measure. The OQ was designed to show when clients have made clinically significant change, Le., have recovered, improved, or deteriorated. All participants completed the OQ during intake interviews and before each treatment session. Participants were randomly assigned to a group whose therapists had access to their OQ responses or to a group whose therapists did not. Participants in the experimental group were expected to have better treatment outcomes. Findings were inconclusive. A t test was used to analyze the difference between groups in mean pre- to post- treatment change scores. Although the 3.1 point difference was in the predicted direction, it was not significant. In a non-statistical analysis, normalized recovery rates were calculated and used to plot dose-effect curves for the two groups. The comparison showed that the benefits of treatment for both groups accrued only within the first eight sessions; however, the experimental group had a large (over 30%) advantage over the control group in terms of peak recovery rate. A comparison of dose-effect curves for both recovered and improved clients, revealed a smaller difference in peak recovery/improvement rates. Dose-effect curves from this study were compared with those reported by other researchers and clear differences were found. Participants in the current study recovered across a much narrower range of sessions and achieved smaller peak recovery rates than clients studied previously. However, this study’s small sample size increases the likelihood that the obtained dose-effect curves are unstable. The inconclusive findings underscore the need for further research to test the assumption that feedback from continuous outcome assessment enhances outcome.